Review of uptake of interventions to reduce mother to child transmission of HIV by women aware of their HIV status.
OBJECTIVE
To examine the change in uptake of interventions to reduce transmission of HIV from mothers to infants from January 1994 to July 1997.


METHODS
Review of mother-infant pairs who presented for infant diagnosis of HIV infection.


METHODS
Central London hospital with facilities for diagnosis of infant HIV infection.


METHODS
57 consecutive mother-infant pairs, mainly from central London but also referred from surrounding hospitals.


METHODS
Data were collected on mother's country of origin; CD4 count at delivery; plasma HIV RNA copies/ml; mode of delivery; antiretroviral therapy; infant feeding; and HIV infection in infants.


METHODS
HIV infection of infants.


RESULTS
The vertical transmission rate was 12% (7 pairs; 95% confidence interval 3% to 22%). All mothers chose not to breast feed. The caesarean section rate was 53% (30/57). Antiretroviral therapy was taken by 68.5% (39/57) of mother-infant pairs. With antiretroviral therapy or caesarean section, or both, transmission occurred in 6% (0% to 13%) of pairs (3/50). During the 24 months of 1994 and 1995, 21% (4/19) of infants were infected with HIV; 7.9% (3/38) were infected over the 19 months January 1996 to July 1997. The caesarean section rate did not change over these periods. Use of antiretroviral therapy increased from 31.5% (6/19) to 86.8% (33/38) (P < 0.0001).


CONCLUSIONS
Women with a diagnosis of HIV infection acted to reduce the risk of transmission to their infants. Uptake of antiretroviral therapy increased significantly over time, and the caesarean section rate was persistently high.
Lyall
E G
EG
Department of Paediatrics, Imperial College School of Medicine at St Mary's, London. h.lyall@ic.ac.uk
Stainsby
C
C
Taylor
G P
GP
Ait-Khaled
M
M
Bingham
S
S
Evans
J A
JA
Wright
A
A
Weber
J N
JN
McClure
M O
MO
Walters
S
S
Tudor-Williams
G
G
D000349:Africa / Q000208:ethnology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001364:Awareness; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000635:transmission; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008131:London / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000208:ethnology / Q000517:prevention & control*; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine